Summary

I thought I'd take a few minutes to summarize the previous five posts as they have all been links.

The links are to numerous writers including a doula, a birth educator, academics and patients all suggesting that cesarean sections can be done in a way that results in a better experience for the birthing woman.

Based on the reading I have done, links mentioned and my personal experience would like to suggest that all women considering childbearing give at least a little thought to the potential of having a cesarean in order to advocate for their wishes should one become necessary.

In hindsight it would have been helpful for me to have thought about the following so that I could have advocated for myself:

My wish to view the birth by mirror or lowering the screen.
Asking to have the surgery described for me.
How I wished to have the moment of birth announced.
Asking for a view to the pediatric area.
Asking to have the newborn exam delayed until I had met my baby.

Also I feel extremely lucky that I was allowed the chance to:
Have skin to skin contact in the OR.
Breastfeed in the OR.

I'm sure not everyone wants the same things as me. Maybe the last thing some women would like is to have surgery described to them. Still having considered that in advance and being able to ask the attendants to use distraction techniques would help personal choice enter a situation where loss of control can be very overwhelming.

I know I spent more time considering genetic testing then I did having a cesarean, yet my risk of baby having a genetic abnormality was significantly less then the more then 1 in 4 chance Canadian women have of having a cesarean.

For me it came down to an emergency situation, everything moved very quickly and now I see how a little more prep could have saved me much heartache.

The Faceless Caesarean

Above is a call to action to help better cesarean experience from:

The Faceless Caesarean by Caroline Oblasser.
"Caesarean mothers in words and photographs"

I found this book fascinating and I'm glad that it exists because more people need to know the truth about Cesareans. Women's own narrative accounts are so helpful in understanding what it's really like. Also by interviewing 162 women this book is one of the few firsthand authorities I've found on what women want when surgical birth IS necessary.

The photos are also very powerful.

Her book is available at www.caesareanbook.com

Natural Cesarean

I've got to say there are some things I just love about the web. Thanks to Karen, who left a comment on one of my posts I have been researching Prof. Fisk who is pioneering "Natural Cesareans". Yay! Now all we need to do is get this info out there.

The natural caesarean: a woman-centred technique

J Smith,^a F Plaat,^b and NM Fisk^a

"Although much effort has gone into promoting early skin-to-skin contact and parental involvement at vaginal birth, caesarean birth remains entrenched in surgical and resuscitative rituals, which delay parental contact, impair maternal satisfaction and reduce breastfeeding. We describe a ‘natural’ approach that mimics the situation at vaginal birth by allowing (i) the parents to watch the birth of their child as active participants (ii) slow delivery with physiological autoresuscitation and (iii) the baby to be transferred directly onto the mother's chest for early skin-to-skin. Studies are required into methods of reforming caesarean section, the most common operation worldwide."

Please cite this paper as: Smith J, Plaat F, Fisk N. The natural caesarean: a woman-centred technique. BJOG 2008;115:1037–1042.

Here is a link to an abstract of his article, and a chance to download to the whole thing:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2613254/


Here is a link to an magazine article about this new procedure.
http://www.timesonline.co.uk/tol/life_and_style/health/article6028478.ece

Planning a Good Cesarean

Here is a link to a

UK Midwifery Archives page titled "Planning a Good Caesarean Section"

http://www.radmid.demon.co.uk/csgood.htm

It's amazing how much I can relate to the stories, particularly the first complaint of "Karen, 33"
Who writes:
"Things that didn't help:
Not being given the choice to see my daughter being born. I would have liked the screen to be down so I could see but this wasn't offered - and at the time I was too concerned for my daughter's welfare to even think of it but would have said yes if asked."

Also pretty amazing is the story by "Tikki" she sais:

"I read a magazine article about a woman in the UK who birthed her own baby with a C/S! The surgeon asked her to reach down to feel the baby's head, and she just started to pull, and he let her! There's active involvement."

I am starting to imagine a time when disconnected "sheet-up cesareans" are as passe as lifting the baby up by it's heels and smacking it's bottom!

Spiritual Cesareans

Here is another link I found.
It's about doula care for cesarean sections .
It's the reflections of a doula who took a day course with Lanell Coultas about attending cesareans.

http://doulaemily.blogspot.com/2008/12/experiencing-spiritual-cesarean.html

I wonder how many hospitals allow for doula care during cesareans?

Spiritual Cesareans

The term "spiritual cesarean" popped into my mind a few days ago, so this morning I searched the web. This link is to the Birthing From Within website and I thought it started to address the idea I feel forming. Definitely worth a read.

http://www.birthingfromwithin.com/cesarean_birth

My Story

The more reading I do the more I feel at odds with the terms I find.
The birth of my son was not "normal" or "natural". It seems that once I crossed over from vaginal childbirth to the other side I am alienated from all the things that I feel define me.

And I'll admit before I had a cesarean I had an idea about them that was formed by the media. I thought they were the easy way out. What else could the term "to posh to push" mean?
I pushed my first baby out- and it hurt, took over a day for him to be born, and it took just as much time to much time to sew me up as my cesarean did. I felt like a trouper that I had done it "all natural". I had no idea that the reality of being cut open to have a baby is certainly not easier, maybe a bit more predictable, but not easier.

To me there seem to be two camps, one driven by the "natural" side, advocating for vaginal births, home birthing options, midwifery care, and avoidance of medical interventions.
The other camp is the medical establishment with a "better safe then sorry" approach to childbirth and the use of modern interventions. This dichotomy has existed for hundreds of years and the fact that women have a choice at all has been hard fought. Midwifes have only legally been allowed to be primary birth attendants in B.C. for just over 10 years.

Before my cesarean, I knew where I belonged, I'm an all natural girl . Now I feel rejected by the natural side, like I lost the good fight. I failed to be a statistic that will help women get greater choices and more satisfying births. I'm now on the tallies of why we need medical interventions.

I often wonder why almost six months after my birthing experience I am still compelled to examine my experience. I know that there must be a reason, and as I listen to more stories of women in my community I feel that perhaps this purpose is to help bring more choices to families who have unplanned cesareans. There are so many little ways I feel the natural aspect of child birth were unnecessarily stripped away from me.

There are many books on repeat cesareans, vbacs, cesarean prevention and such, but I'm yet to find anything that addresses how to make unplanned cesareans better.

Maybe it's time to speak up and all us natural girls need to help each other find a new term.
"My natural cesarean?"

Holding my new nephew a couple of days ago, I ran my hand over his head I felt the complex pattern of texture to his scull.
The story of his path through the birth channel etched on his head.
I miss that in my new son. I was so very bothered by his head when he was new. The geometric roundness of his never "squished" head was unusual to me.
I wonder more about his now. Once babies are born we are very aware that their heads need to be protected. I would be fearful for his life if he was to have something happen to him that changed the shape of his head.
How will he be affected by having a brain that was never crushed through my pelvis? How will the millions of people birthed in this way be affected?
Perhaps there is some reason for these births in the cosmic scheme of things. Maybe these babies who enter our physical world in this way are gifted with a more celestial brain?
There is a theme that runs through out many mythologies that women are destined to feel great pain and sacrifice in order to bring forth life.
Surgical birth felt to me like a greater sacrifice then regular birth, perhaps this extra sacrifice has a purpose. I'll never know, but it makes me feel good to think that besides ensuring a safe delivery for him (in itself a great thing), that his method of arrival may serve a greater good. If I know anything it's that balance finds it's way.

My Story

People call me an earth mama, I make art, eat orgainic food, drink herbal concoctions, do yoga and as my brother put it: Im the last person he would have thought would have a cesarean.
Still, I was surprised at the huge reaction I had to having a cesarean section -besides just not much liking having emergency surgery and the trauma of fearing for my babies life, I struggled to relate to what had just happened. I felt a bit like I had been swallowed by medical machine that had taken over my body, invaded me with plastic tubes, dizzying narcotics and faceless people who looked right inside the depths of my body. Yet this same alien system had produced my beautiful baby.
I felt compelled to find out as much as I could about cesareans. I searched my local library catalog and found myself looking at a list of books topped by one called Not Of Woman Born.
This was how I felt. Somehow I had brought forth a baby without him being born.
I really wanted to find a way to pull his birth back into myself, to accept that I had birthed him. He had been brought forth from my body, covered in my blood, even if I didnt know the exact moment we became two.
I was hungry for information.
Pouring over the medical intervention chapters in my pregnancy books and talking to everyone I knew who had one just brought me tears not progress.
I had my first moment of reconnection when I read about tribal people in Africa, shamanic healers with well developed methods of performing cesarean births long before they were common in western cultures. Even though Im obviously not a tribal African, I felt I could relate to the earthiness of those people performing cesareans by torch light.
I found a first step in re-finding me.

History of Cesareans

I found this interesting reading online:

Cesarean Section- A Brief History by Jane Eliot Sewell Ph.D.
"A brochure to Accompany an exhibition on the History of Cesarean Section at the National Library of Medicine" held in 1993


I found this to be a fascinating way to learn about the history of the modern cesarean birth.
It is an extensive article with interesting historical depictions of cesareans being preformed and an overview of historically recorded cesareans.